Transgender individuals have lived, loved and worked in society potentially as far back as the time of the ancient Egyptians. However, transgender history is not easy to trace because so many transgender individuals have had to learn to hide their true identity in order to simply survive.
Today, the status of transgender individuals in Westernized cultures is slowly shifting, largely due to the courage of a handful of transgender activists who are choosing to use their public platforms to raise the issue and push for change. At the forefront of the movement is hard data pointing to the high financial and emotional cost of living as a transgendered person.
According to the National Center for Transgender Equality (NCTE), “transgender” is a term that refers to a person whose assigned biological sex and expressed gender identity do not match.
In this definition, gender identity can refer to male, female or other. Some transgender individuals, for instance, identify strongly as male even though they were born as biological females. And some transgender individuals identify strongly as female even though they were born as biological males. But some individuals identify as asexual, pan-sexual or other, regardless of whether they were born into a male or a female biological body.
An older term for a personal who is transgender is “transsexual,” but it is not a preferred term in the movement today.
Gender Reassignment: Let Me Count the Financial Costs
As in other walks of life, within the transgender community, different individuals have different preferences about how they wish to express their gender identity. For some few who have ample means, this may mean choosing to undergo a full course of complete gender reassignment.
For most transgender individuals, however, the current financial costs associated with this course of action are simply out of reach. In this more common scenario, it often boils down to creative coping strategies to keep harassment, discrimination, misunderstanding at bay while expressing their gender identity authentically as best they can.
Time magazine states that transgender surgery, which represents just one facet of the complete gender reassignment process, can run up a tab of $100,000 or more.
Here is an outline of one potential pathway to complete gender reassignment, along with estimated average costs for each facet:
- Pre-requisite counseling therapy (48 months): $1,000 (produces a letter required by law before a surgeon can perform gender reassignment surgery)
- HRT (hormone replacement therapy) (time varies): $1,500 per year
- Gender reassignment surgery (male to female, female to male): $30,000
- Facial reassignment surgery: $30,000
- Breast augmentation/mastectomy: $5,000
The Philadelphia Center for Transgender Surgery publishes a complete price list for basic and optional transgender surgical procedures. Different procedures may be indicated based on the individual person’s needs and goals.
These hard costs do not reflect certain additional unavoidable costs that come as part of the package during a gender reassignment transition, such as:
- Lost work time.
- Inability to obtain medical insurance to cover all or even part of the medical costs.
- Complications after surgery that require more care.
- Being let go by an employer (typically for different reasons than those of gender or medical health needs).
- Lack of family and social support before, during and after gender reassignment that requires hiring nursing care and drivers to get to and from appointments and pick up prescriptions.
- Costs of medical checkups and ongoing maintenance, including everything from basic hair removal (electrolysis) to lifestyle counseling (often necessary to learn to “fit in” to society in post-gender reassignment life).
A High Emotional Price
But financial costs do not represent the only price a transgender person must pay for living inside a body that doesn’t feel like their own.
Over the last few years, certain highly publicized suicide cases have propelled the plight of transgender individuals into the mainstream. News media has offered extensive coverage, including face-to-face interviews with suicide survivors. USA Today states in one such interview that 4 out of every 10 transgender individuals attempt suicide.
As well, transgender individuals at any stage in their journey often face severe emotional trauma, abuse and distress, including (but not limited to) these sources:
- Peer and instructor bullying, harassment, ostracism and even death threats.
- Family rejection and disowning by parents and relatives.
- Inability to find work and earn a living.
- Feeling forced to present as the biological gender for safety reasons.
- Not being able to have therapy or counseling for support due to finances or job limitations.
- Inability to find quality peer or social support through local groups.
- Social isolation that leads to anxiety, depression and suicidal thoughts or actions.
The life of a transgender person today is incredibly difficult both emotionally and financially and in other ways as well. Gender reassignment costs continue to be prohibitive while the medical community debates whether these procedures are “medically necessary.”
However, the tide is slowly shifting in part due to activism by famous transgender persons and individual personal stories from everyday people living transgender lives.